Pediatric tracheomalacia

What is pediatric tracheomalacia?

Tracheomalacia is a condition in which the trachea (windpipe) collapses when your child breathes out.

Your child’s trachea is supported by rings of cartilage that enable it to stay open so your child can breathe in and out. If something happens to damage the cartilage, the trachea can collapse partially.

If your child has tracheomalacia, it can be hard to breathe and you may hear a vibrating noise or wheezing sound when they breathe out. Most of the time, the first signs of tracheomalacia are seen when an infant is between four and eight weeks old. However, it can happen to a child of any age. Most children outgrow tracheomalacia.

Tracheomalacia can lead to recurrent respiratory problems and eventually may cause lung injury. This is because when the trachea collapses, it keeps mucus and lung secretions from being expelled and traps them in the lungs. Children who already have chronic lung disease, acid reflux disease or tracheoesophageal fistula are more likely to have tracheomalacia.

What are the different types of pediatric tracheomalacia?

There are two main types of the condition:

1. Type 1 tracheomalacia happens when a child is born with defects in the cartilage in their trachea.

2. Type 2 tracheomalacia happens when there is airway compression due to a trapped object, or after a surgery to repair another condition.

What are the signs and symptoms of pediatric tracheomalacia?

• Apnea (halt in breathing) in infants

• Choking during feeding

• Chronic cough

• Chronic chest congestion and infections

• Difficulty breathing during activity

• Frequent bronchitis and pneumonia 

• Noisy breathing

• Stridor (rattling noise when breathing)

• Wheezing during exhalation

What are the causes of pediatric tracheomalacia?

Tracheomalacia is usually a congenital disease, meaning children are born with the condition.

When it is acquired later, as in Type 2 tracheomalacia, it may be caused by:

• Abnormal blood vessels in the chest (vascular rings)

• Previous surgery for another condition

• Recurring infections

• Tracheostomy tubes used in treatment for another condition

• Tumor or mass pushing on the trachea